U.S. patent number 4,799,884 [Application Number 07/116,672] was granted by the patent office on 1989-01-24 for expansion/buccal shield appliance.
Invention is credited to Earl O. Bergersen.
United States Patent |
4,799,884 |
Bergersen |
January 24, 1989 |
Expansion/buccal shield appliance
Abstract
An orthodontic appliance is provided which has a buccal shield,
an occlusal plate, a lingual flange for the incisors and slots for
receiving the posterior teeth. The posterior segment of the
appliance is preformed wider than the patient's lateral posterior
teeth spacing and the slots are open lingually to permit the
patient's tongue to press against the lingual surface of the
posterior teeth to cause them to expand buccally. The slots are
angled posteriorly to cause the posterior teeth to move
distally.
Inventors: |
Bergersen; Earl O. (Winnetka,
IL) |
Family
ID: |
22368555 |
Appl.
No.: |
07/116,672 |
Filed: |
November 4, 1987 |
Current U.S.
Class: |
433/6 |
Current CPC
Class: |
A61C
7/08 (20130101) |
Current International
Class: |
A61C
7/08 (20060101); A61C 7/00 (20060101); A61C
003/00 () |
Field of
Search: |
;433/6 ;128/136 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Wilson; John J.
Attorney, Agent or Firm: Hill, Van Santen, Steadman &
Simpson
Claims
I claim as my invention:
1. An orthodontic appliance for expansion of at least one of the
upper or lower arches in a patient comprising generally U-shaped
appliance comprising:
a buccal shield portion for overlying a labial-buccal surface of at
least one of the upper or lower rows of the patient's teeth,
an interocclusal plate extending lingually of said shield,
a lingual flange to overlie a linual surface of the patient's
incisors, and
a plurality of projections defining tooth receiving slots
therebetween extending longitudinally from said buccal flange,
said projections being spaced to project between each of the
posterior teeth of the patient.
2. An orthodontic appliance according to claim 1, wherein said
projections are angled anteriorly from their points of attachment
to the buccal shield to guide the teeth engaged therebetween
distally and buccally.
3. An orthodontic appliance according to claim 1, wherein said
appliance is formed of a resilient molded material and including a
resilient wire member molded in the interior of said appliance to
assist in retaining the shape of the appliance.
4. An orthodontic appliance according to claim 1, wherein said
buccal shield overlies the buccal surface of both the upper and
lower rows of the patient's teeth.
5. An orthodontic appliance according to claim 1, including a wedge
shaped projection positioned between the lateral incisor and the
canine to drive the canine buccally and distally.
6. An orthodontic appliance for expansion of at least one of the
upper or lower arches in a patient, comprising a generally U-shaped
appliance comprising:
a buccal shield portion for overlying a labial buccal surface of at
least one of the upper or lower rows of the patient's teeth,
an interocclusal plate extending lingually of said shield, and
a plurality of individual slots for receiving the posterior teeth
of said patient,
said slots being open lingually and being bounded on a buccal side
by an anterior surface of said buccal flange, said anterior surface
being spaced buccally from the buccal surface of said teeth,
whereby, the patient's posterior teeth will be expanded buccally by
the force of the patient's tongue on the posterior teeth.
7. An orthodontic appliance according to claim 6, wherein said
slots include sidewalls therebetween which project lingually from
said buccal shield, said sidewalls being angled anteriorly from
said buccal shield to said open lingual side of said slots to
additionally urge the posterior teeth distally.
8. An orthodontic appliance according to claim 6, wherein said
interocclusal plate has a lingual edge which terminates buccally of
a lingual surface of the posterior teeth.
9. An orthodontic appliance according to claim 8, wherein said
lingual edge of said plate does not extend lingually of a lingual
surface of said posterior teeth after their buccal expansion.
10. An orthodontic appliance according to claim 6, wherein said
appliance is preformed.
11. An orthodontic appliance according to claim 6, wherein said
appliance is custom made.
12. A method of positioning teeth comprising the steps of:
providing an orthodontic positioner of the type which is generally
U-shaped in plan view and includes in at least one of the top or
bottom thereof a tooth receiving trough for receiving and
positioning teeth, said providing step comprising selecting a
preformed positioner having in the trough or troughs therein
depressions for the patient's incisor teeth and individual slots
for the patient's posterior teeth, said depressions for the incisor
teeth being sized at least large enough for the normal spacings of
the incisors and said slots for the posterior teeth being open on
the lingual side and having a buccal wall laterally spaced at a
distance greater than the normal lateral spacing of the buccal
surface of the posterior teeth of the patient,
applying the positioner for use by a patient during at least one of
a deciduous, mixed or permanent dentition stage of development,
whereby such use causes the posterior teeth to expand buccally.
13. The method of claim 12, wherein said providing step includes
providing a positioner having tooth receiving troughs in both the
top and bottom thereof.
14. The method of claim 12, wherein said providing step includes
providing a positioner wherein the slots for receiving the
posterior teeth angle posteriorly.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention:
The invention relates to tooth positioning appliances, and in
particular to an appliance to be used with deciduous dentition or
mixed dentition to expand the posterior segments.
2. Description of the Prior Art:
Over crowding of the teeth, particularly the anterior teeth is one
condition which can be corrected with orthodontic treatment.
Oftentimes metallic bands and wires are used in the permanent
dentition stage to provide the desired spacing. There have also
been provided devices such as my prior device disclosed in U.S.
Pat. No. 4,139,944 in which a plastic removable positioner is
provided for use in correcting certain conditions in a permanent or
mixed dentition stage.
SUMMARY OF THE INVENTION
The present invention provides a U-shaped appliance which may be
used for the upper and lower arches with a connecting isthmus or
plate that engages the occlussal surfaces of the teeth. The
appliance can be used for either deciduous teeth only or can be
used for mixed dentition or permanent dentition. The mixed
dentition would consist of permanent upper and lower incisors
(central and lateral incisors) and first permanent molars,
deciduous canines, decidious first molars and deciduous second
molars. The lateral spacing of the inter-canine, first deciduous
molar-to-molar and the second deciduous molar-to-molar would be
expanded for example by about 7 mm from their normal position and
the mesial-distal canine-to-canine distance would be increased for
example by about 4 mm from its normal distance.
Individual slots, open lingually, are provided in the appliance for
the posterior teeth and because of the early stage of development
of the patient's mouth at the age up to mixed dentition, the
posterior teeth will move to the expanded position of the preformed
appliance to provide increased spacing for the incisors.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is an occlussal view of an orthodontic appliance embodying
the principles of the present invention.
FIG. 2 is a side sectional view of the appliance taken generally
along the line II--II of FIG. 1.
FIG. 3 is a side sectional view of the appliance taken generally
along the line III--III of FIG. 1.
FIG. 4 is a sectional view through the occlussal plate area of the
appliance and showing an embedded wire.
FIG. 5 is a side prespective view of an appliance incorporating an
embedded wire.
FIG. 6 is a partial sectional view of an appliance without a
wire.
FIG. 7 is an enlarged partial view of a posterior portion of the
appliance showing the interaction of the teeth with the
interproximal projections.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
In FIG. 1 there is illustrated an appliance generally at 10 which
is generally U-shaped in occlussal or plan view and which includes
an outer buccal flange 12 which overlies the buccal surface of at
least one of the upper or lower rows of the patient's teeth.
Projecting lingually of the buccal shield 12 is an occlussal plate
or shelf 14 which is to engage an occlussal surface of the
patient's teeth. A lingual flange 16 is provided at an anterior
bight portion of the U-shaped appliance to overlie a lingual
surface of at least one of an upper or lower set of central and
lateral incisors I. The lingual flange 16 terminates prior to the
canines C so that the patient's tongue will be free to engage the
lingual surface of the posterior teeth (canines and molars M). The
buccal shield 12 holds the cheeks and lips away from the buccal and
labial surfaces of the patient's teeth.
The appliance is a preformed or custom-made device fabricated of a
molded resilient material such as plastic that conforms to the
anterior teeth (central and lateral incisors) and, the buccal
shield 12 is spaced laterally away from the posterior teeth. Thus,
the force of the tongue against the posterior teeth causes these
teeth to move buccally to gain extra room for the patient's crowded
or potentially crowded teeth.
A lingual surface 18 of the buccal shield is notched in that it has
lingually extending projections 20 extending therefrom, the
projections 20 being positioned to project into the interproximal
spaces between each of the posterior teeth and a wedge shaped
projection 22 is provided between the canines and lateral incisors.
The projections 20 are angled anteriorly and lingually from their
points of attachment at the buccal shield to thereby define a
buccally and posteriorly directed slot or pocket 24 for receiving
each of the posterior teeth. The slanting of the projections
encourages each buccal tooth to assume an expanded position while
gaining space anteriorly between the canine and the lateral
incisors where the space can be used for the elimination of
crowding in the anterior segment, especially in the lateral-canine
area. Preferably, the expansion of the buccal shield allows for
approximately 1-20 mm of expansion between the canines in the upper
the lower arches as well as approximately 1-20 mm of lateral
expansion between each of the molars. Expansion may be provided for
the anterior segment if desired or needed, but in some instances no
anterior segment expansion would be required.
The wedged shaped projection 22 between the lateral incisors and
the canine causes the canine to drift distally along a distal
surface 26 of the wedge to assume a more expanded but slightly
distal position. As each tooth distal of the canine is expanded, it
in turn migrates slightly distally or at least does not move
mesially as it expands. In this way, the excess space created by
the posterior expansion ends up in the lateral-canine area. If the
canine is missing, the deciduous first molar will still be guided
distally by its mesial interproximal projection 20.
Preferably the appliances are preformed in varying sizes to
accommodate 1.5 mm variations in accumulative mesial-distal widths
of the six permanent anterior teeth in the maxilla. The measurement
can be taken in the maxilla from the distal surface of the left to
right incisor or in a similar way in the mandible. Approximately
thirteen sizes will accommodate about 95% of the population
variations. The expansions in the posterior segments are predicated
upon the normal statistically expected arch widths in each tooth
area (canine, first and second deciduous molars and first permanent
molars) together with an additional 7 mm in arch width of each
tooth area. The appliances may also be custom made to fit
individual patients.
The anterior segment may be increased vertically to a greater
extent than the posterior in order to decrease the vertical
overbitting anteriorly and to encourage the posterior teeth to
obtain more eruption than normally expected as is described in
greater detail in my prior U.S. Pat. No. 3,939,598. The anterior
segment may be decreased to correct open bite or the anterior and
posterior segments may be of equal thickness.
The lingual isthmus or occlussal shelf 14 extends lingually, but
not completely to the lingual surface of the preexpanded position
of the posterior teeth otherwise it would prevent the tongue from
expanding the teeth properly. That is, the shelf has a lingual edge
28 which is to be positioned buccally of the lingual edge of the
buccal teeth. However, if the shelf extends beyond where it will
match the lingual surface of the posterior teeth in their fully
expanded position, it can be trimmed off slightly.
The appliance can be made for an all deciduous dentition, mixed
dentition or all permanent dentition. The only differences would be
the length of the posterior segments and the positions of the
interproximal projections. The appliance can also be premade for
any degree of expansion as well, be it more or less than 7 mm.
The lingual surface of the buccal shield will be slightly more
buccal in the maxilla than the mandible in order to prevent
buccal-lingual cross-bites from occurring. It is possible, however,
to adjust this by trimming on the inside lingual surface if it is
desirous to have one tooth moved more buccally than another,
particularly in the over correction of a cross-bite condition.
The expanded result after wearing this appliance will match the
expansion pre-set into the expanded appliance that has all
posterior sockets present as well as a lingual vertical flange
present lingual to these posterior teeth which is the type such as
that described in my prior patent referred to above. Thus, the
patient can wear that type of appliance as a retaining appliance as
well as to better control the posterior occlusion after
satisfactory expansion with the present invention has been
obtained.
The material of the present appliance 10 can be of any degree of
hardness or softness, whichever is found to respond better with any
particular patient's musculature. There may be several degrees of
hardness of material as an option for certain types of cases, be it
a constricted mouth with heavy powerful buccinator and masseter
muscles which might require a harder, less resilient material,
while a more placid, softer, weaker musculature might be more
comfortable with a softer material.
It also may be beneficial to start out with an appliance that has
minimal expansion and after sufficient expansion has been obtained
with this appliance, the next wider and perhaps harder material
might be used to gain greater expansion. This could continue until
sufficient adequate expansion has been obtained for the patient's
degree of crowding. The appliance is removable so the patient's use
is passive, but it would be preferable for the patient to use the
device as many hours each night and day as possible to gain
adequate expansion.
It also may be preferable to include a wire member 30 molded in the
interior of the appliance to assist in maintaining the desired
buccal expansion dimension of the appliance. The wire 30 may have a
serpentine shape as best seen in FIG. 5 to permit adjustments of
the appliance horizontally as well as vertically or a combination
of horizontal and vertical in a compound bend.
As is apparent from the foregoing specification, the invention is
susceptible of being embodied with various alterations and
modifications which may differ particularly from those that have
been described in the preceding specification and description. It
should be understood that I wish to embody within the scope of the
patent warranted hereon all such modifications as reasonably and
properly come within the scope of my contribution to the art.
* * * * *